Ca circule sur le web : Penn State Health settles with Justice Department for $11.7 million over Medicare claims

Penn State Health will pay more than $11.7 million to resolve allegations the health care system improperly submitted Medicare claims during the span of eight years, the Justice Department announced Wednesday.

More than $7.8 million is due within 30 days of the agreement being finalized. The final signature on the agreement was dated Jan. 31.

Federal regulators agreed to refrain from excluding Penn State Health from Medicare, Medicaid and other federal health care programs. The agreement did not waive any criminal liability.

Penn State Health voluntarily disclosed in October the improper billings related to Medicare annual wellness visit services not supported by medical records. The allegations spanned December 2015 through November 2022.

The Justice Department believed the claims violated Medicare rules and regulations.

“Penn State Health’s Compliance Office discovered a discrepancy with regard to documentation requirements for Medicare Annual Wellness Visits. After discovering these documentation errors, Penn State Health voluntarily disclosed them to the United States Attorney’s Office,” the health system said in a written statement. “We have worked with United States Attorney’s Office and Health and Human Services Office of Inspector General on a settlement and repayment of any reimbursements that did not fully meet Medicare documentation requirements.”

Penn State Health lost $160 million during the fiscal year that ended in 2023, although it said revenue growth and cost controls led to a better trend, PennLive reported in November.

The health system said it had about three months worth of cash on hand as of Sept. 30. The median cash on hand for a health system was about eight months as of August 2022, according to Becker’s Hospital Review.